This study tested the effectiveness of health education versus empowerment education with individuals with a chronic and persistent mental illness. A randomized, controlled trial design was used in 22 community group homes. The Lehman Quality of Life Scale was administered prior to the interventions, immediately following the intervention, and then 6 months later. Health services utilization was also measured. Although Quality of Life scores improved over time, there were no statistically significant differences found between groups in Quality of Life and use of health services. There were clinically important gains (20%) in global quality of life for a specific subset of individuals who endorsed a life low in satisfaction and with little hope for the future, and this also resulted in more expense for resource consumption. Results of this study highlight issues of the length of time to produce changes in individuals with a severe illness and the sensitivity of quality-of-life measures in evaluating interventions.